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Old 09-06-2012
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Default Genitourinary High Yield !

A 64-year-old man is scheduled for hemolysis due to end stage renal disease.He has several year history of hypertension,diabetes, coronary artery disease, hypercholesterolemia, peripheral vascular disease, gout and diverticulosis. Six months ago , he was admitted for urosepsis.Recently his hemoglobin ranged 8.5-9.5 g/dL.He has already been on iron therapy, and now you are considering erythropoieten injections twice weekly. Which of the following is most likely to be seen following eryhtropoietin therapy ?

A. Worsening of hypertension
B. Increase in insulin requirement
C. Increase susceptibility to infections
D. Deterioration in renal function
E. Flare-up of gout
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Old 09-06-2012
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Originally Posted by step_enhancer View Post
A 64-year-old man is scheduled for hemodialysis due to end stage renal disease.He has several year history of hypertension,diabetes, coronary artery disease, hypercholesterolemia, peripheral vascular disease, gout and diverticulosis. Six months ago , he was admitted for urosepsis.Recently his hemoglobin ranged 8.5-9.5 g/dL.He has already been on iron therapy, and now you are considering erythropoieten injections twice weekly. Which of the following is most likely to be seen following eryhtropoietin therapy ?

A. Worsening of hypertension
B. Increase in insulin requirement
C. Increase susceptibility to infections
D. Deterioration in renal function
E. Flare-up of gout
A. Worsening of hypertension due to increased red cell mass.
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Old 09-06-2012
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Originally Posted by step_enhancer View Post
A 64-year-old man is scheduled for hemolysis due to end stage renal disease.He has several year history of hypertension,diabetes, coronary artery disease, hypercholesterolemia, peripheral vascular disease, gout and diverticulosis. Six months ago , he was admitted for urosepsis.Recently his hemoglobin ranged 8.5-9.5 g/dL.He has already been on iron therapy, and now you are considering erythropoieten injections twice weekly. Which of the following is most likely to be seen following eryhtropoietin therapy ?

A. Worsening of hypertension
B. Increase in insulin requirement
C. Increase susceptibility to infections
D. Deterioration in renal function
E. Flare-up of gout

YUP .......A ................
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Old 09-07-2012
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Originally Posted by step_enhancer View Post
A 64-year-old man is scheduled for hemolysis due to end stage renal disease.He has several year history of hypertension,diabetes, coronary artery disease, hypercholesterolemia, peripheral vascular disease, gout and diverticulosis. Six months ago , he was admitted for urosepsis.Recently his hemoglobin ranged 8.5-9.5 g/dL.He has already been on iron therapy, and now you are considering erythropoieten injections twice weekly. Which of the following is most likely to be seen following eryhtropoietin therapy ?

A. Worsening of hypertension
B. Increase in insulin requirement
C. Increase susceptibility to infections
D. Deterioration in renal function
E. Flare-up of gout
A.) worsening of hypertension due to increased red blood cells=> hyperviscosity?? is that right?
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Old 09-08-2012
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Answer A

Erythropoietin Side effects (Very High Yield)-

1.Worsening of hypertension-Seen in approx 30% of patients.Even hypertensive encepalopathy can occur when there is a rapid rise in BP.Exaclty how it causes HTN is not well understood.Treatment include removal of fluid(via dialysis) and use of anti-hypettensive drugs (beta blockers and vasodilators are preferred). Prevention involves slowly raising the hematocrit, with a goal hematocrit of 30-35%

2.Headaches .Seen in 15% of patients.

3.Flu-like syndrome: this is seen in 5% of patients.It is responsive to anti-inflammatory drugs, and is less commonly seen with subcutneous erythropoietin adm.

4.Red cell aplasia. this is rare but potential side effect
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